Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
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Medial temporal lobe epilepsy (mTLE) has been associated with widespread white mater (WM) alternations in addition to mesial temporal sclerosis (MTS). Herein, we aimed to investigate the correlation between disease duration and WM structural abnormalities in mTLE using diffusion MRI (DMRI) connectometry approach. ⋯ Our results were obtained from DMRI connectometry, which indicates the connectivity and the level of diffusion in nerve fibers rather just the direction of diffusion. Compared to previous studies investigating the correlation between duration of epilepsy and white matter integrity in mTLE patients, we detected broader and somewhat different associations in midline structures and component of limbic system. However, further studies with larger sample sizes are required to elucidate previous and current results.
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Randomized Controlled Trial
Effects of fluoroscopy-guıded intraartıcular injectıon, suprascapular nerve block, and combınatıon therapy ın hemıplegıc shoulder paın: a prospective double-blınd, randomızed clınıcal study.
To investigate the effect and superiority of fluoroscopy-guided intraarticular shoulder injection (IAI), suprascapular nerve block (SSNB), and combination treatment in hemiplegic shoulder pain (HSP). ⋯ IAI, SSNB, and the combination treatments are reliable and effective treatment modalities that provide pain relief and an increase in shoulder passive ROMs in HSP.
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Migraine is a common, severe disease, affecting the brain and blood vessels, causing much pain, time missed from work and family, and severe disability. It affects approximately 12% of most Western populations studied and affects women three times more than men. ⋯ It affects less than 0.1% of the population and is slightly more prevalent in men than women. Although we have some acute care and preventive medications for both types of headache, no treatment is optimal for each patient and some will not respond well or have significant adverse events to existing therapies.
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The advent of anti-CGRP medications is an example of translational research made real. Pioneering research by Drs. Lars Edvinsson and Peter Goadsby has yielded the monoclonal antibody therapeutics and will likely also result in the gepants. ⋯ They work in patients who have already had lack of success with at least 2-4 previous preventive medications. Pent-up demand for designer, well-tolerated, and effective migraine preventive medication in the USA has resulted in more than 100,000 individual patients prescribed erenumab from May to December of 2018, and the numbers continue to increase. The preventive treatment of migraine in the USA has shifted dramatically, and is likely to do so in the rest of the world as well.
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The aim of this study was to evaluate the efficacy of ultrasound-guided suprascapular block treatment in patients with painful hemiplegic shoulder whose pain was not reduced after conservative treatment. ⋯ The ultrasound-guided SSNB is a safe and more effective treatment than conservative treatment for painful hemiplegic shoulder. Further studies are needed to compare ultrasound-guided and non-guided suprascapular blocks as treatments for hemiplegic shoulder pain.